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Reinsurance Operations Specialist
2 months ago
Key Responsibilities:
- Collaborate closely with external reinsurance carriers and internal Claims Department to ensure timely receipt, reporting, and processing of all claims eligible for stop loss reimbursement.
- Provide necessary updates to internal teams, vendors, and clients as required.
- Complete and submit necessary documentation to reinsurance carriers for specific and aggregate claims, including but not limited to 50% notifications, claim reimbursements, and additional information as requested by the carrier.
- File stop loss reimbursement claims for designated clients in accordance with the requirements of each stop loss contract.
- Monitor reimbursements from stop loss carriers.
- Engage with general underwriters, carriers, and clients to resolve any issues related to stop loss reimbursement.
- Maintain an updated spreadsheet of filed, outstanding, and denied reinsurance claims.
- Generate, maintain, and distribute weekly and monthly reports to the CFO, Claims Director, and Client Relations Consultants for assigned clients.
- High School diploma required; some college education preferred.
- A minimum of 1 year of experience working with Reinsurance Carriers.
- At least 1 year of experience managing stop loss claims.
- A minimum of 3 years of experience in the Healthcare claims sector.
- At least 1 year of experience in a Third-Party Administrator (TPA) environment.
- Ability to perform data entry tasks efficiently and accurately.
- Proficient in computer applications, including Word, Excel, Outlook, and Claims Systems.
- Basic understanding of accounting principles.
- Experience with ICD-10 and CPT coding is preferred.
- Highly organized and detail-oriented.
- Excellent written and verbal communication abilities.
NTT DATA Services is a recognized leader in IT and business services, including cloud, data, and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we assist clients in transforming through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration, and global data centers. We are committed to our clients' long-term success.
NTT DATA Services is an equal opportunity employer and considers all applicants without regard to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is $22-$24. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.
